INSIDE LOOK

THE DAY-TO-DAY OF A BONE MARROW TRANSPLANT NURSE

Date Published: March 12, 2017

Meet Michelle Picconi, RN, BSN, a bone marrow transplant nurse and nurse practitioner student. We interviewed Michelle about a work + study + life balance, the day-to-day of the bone marrow transplant unit, and advice she would give to nursing students. This is one interview you will be glad you read!

Tell us about your background as a nurse.

I started off on a Medical/Surgical/Oncology unit and worked there for two years, one year of night shift and one year on day shift. I then switched over to an inpatient Bone Marrow Transplant unit and worked there for a year. I have been at my current position as a nurse in the Outpatient Bone Marrow Transplant Clinic for two years and counting now!

How did you get started in the bone marrow transplant unit?

I received my chemotherapy/biotherapy provider card when I was working on then Medical/Surgical/Oncology unit. I started working more frequently with oncology patients and fell in love with the patient population. I switched over to Bone Marrow Transplant and began to focus solely on blood cancers, as the typical acuity of each patient was higher, and I enjoyed the challenge. In addition to this challenge, the world of blood cancer treatments and protocols are always changing, so I never feel bored or complacent.

As a bone marrow transplant nurse, what does your typical day look like?

In the outpatient setting, we typically take care of 5 – 7 patients with multiple reasons for visits. The visits can be for lab draws, chemotherapy, an outpatient autologous transplant, neutropenic fever, or acute/chronic graft versus host disease. Based on the reasoning for the visit, your patient will be at clinic anywhere from 1-10 hours. Necessary skills include IV starts and venipunctures, handling and infusing chemotherapy, patient education, and infusion reaction management.

What is the most exciting part of your job?

The most exciting part of my job is seeing what new treatments are coming out, what improvements we have made to current therapy regimens, and of course seeing our patients get into remission!

What is the toughest part of your job?

The number of deaths in this patient population can be overwhelming at times. By the time a patient passes, you are close with not only them but their families and have seen them through so, so much in terms of endless treatments, relapses and remissions, and pain and suffering to an extent that can seem inhumane at times. It can be the most emotionally taxing job at times, and is something you never really “just get used to.” Despite this, it truly is a privilege to help patients fight this fight and I am so lucky to work with these patients. They are truly amazing and restore my faith and hope in humanity on a daily basis.

Which courses in nursing school helped you the most to prepare for this role?

My Care Management courses.

Is there anything that you wish you knew when you joined your unit that you know now?

I wish I had more extensive knowledge about how the immune system works (a deeper level of understanding, not just a basic overview) and how to best care for immunocompromised patients.

What advice would you give to a nursing student interested in joining a bone marrow transplant unit?

Work on a Medical/Surgical, Telemetry, or Oncology unit prior to starting. You need to have a solid foundation of skills and basic nursing knowledge prior to entering something so specialized. It is the hard way to do things, but I do feel like it makes you a better nurse.

You are also in nurse practitioner school, how do you balance both your role as a student and a working nurse?

It is extremely challenging! You have to learn how to prioritize and recognize when you need to step back and truly let yourself have a mental break. It is very easy to get burned out from a strict study/work schedule so you need to have some self-awareness and know when to give yourself a break. I must say, I do enjoy working while in school, though, it helps you become a better nurse while you are on the floor and slowly but surely you find yourself switching your mindset from nurse to nurse practitioner. You begin coming up with your own differential diagnoses and treatment plans at work!

What made you decide to go to nurse practitioner school?

I was just ready for the next step in my career, ready to be challenged, and ready for a new scope of practice. I overheard another nurse state something along the lines of, “If you’re ever bored in nursing, it’s your own fault!” and this has stuck with me throughout my career. The opportunities are endless as a nurse practitioner and this truly excites me. In addition to this, I want to provide the best care to patients and furthering my degree will help me to do so.

What advice would you give a nursing student who is also considering nurse practitioner school?

Work for a few years first! Find out what your niche is is nursing, what you like and don’t like about the profession, and what excites you. Find out if you like working outpatient, inpatient, ICU status, etc…the first couple of years are your time to fly! Think about your decision to further your degree and don’t rush straight from undergrad to graduate school. You assume a huge amount of responsibility when you decide to become a nurse practitioner and you need to make sure this is something you truly want and are ready for. The first couple of years as a nurse are so overwhelming and the learning curve is steep, but give yourself time to be comfortable as an RN before pursuing your masters. You will know when the right time is to go back to school, and don’t talk yourself out of going back, you can do it!

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